title: Pain measurement as part of primary healthcare of adult patients with sickle cell disease.
abstract: OBJECTIVE
  The aim of this exploratory, cross-sectional study was to evaluate pain in sickle cell disease patients and aspects related to primary healthcare.
  
  
  METHODS
  Data were obtained through home interviews. The assessment instruments (body diagram, Numerical Pain Scale, McGill Pain Questionnaire) collected information on the underlying disease and on pain. Data were analyzed using the Statistical Package for Social Sciences program for Windows. Associations between the subgroups of sickle cell disease patients (hemoglobin SS, hemoglobin SC, sickle β-thalassemia and others) and pain were analyzed using contingency tables and non-parametric tests of association (classic chi-square, Fisher's and Kruskal-Wallis) with a level of 5% (p-value < 0.05) being set for the rejection of the null hypothesis.
  
  
  RESULTS
  Forty-seven over 18-year-old patients with sickle cell disease were evaluated. Most were black (78.7%) and female (59.6%) and the mean age was 30.1 years. The average number of bouts of pain annually was 7.02; pain was predominantly reported by individuals with sickle cell anemia (hemoglobin SS). The intensity of pain (Numeric Pain Scale) was 5.5 and the quantitative index (McGill) was 35.9. This study also shows that patients presented a high frequency of moderately painful crises in their own homes.
  
  
  CONCLUSIONS
  According to these facts, it is essential that pain related to sickle cell disease is properly identified, quantified, characterized and treated at the three levels of healthcare. In primary healthcare, accurate measurement of pain combined with better care may decrease acute painful episodes and consequently minimize tissue damage, thus improving the patient's overall health.
authors.affiliation: Universidade Federal do Triângulo Mineiro - UFTM, Uberaba, MG, Brazil.
authors.forename: Andreza Aparecida Felix
authors.initials: AA
authors.lastname: Signorelli
authors.forename: Sonia Beatriz Felix
authors.initials: SB
authors.lastname: Ribeiro
authors.forename: Helio
authors.initials: H
authors.lastname: Moraes-Souza
authors.forename: Lucas Felix
authors.initials: LF
authors.lastname: de Oliveira
authors.forename: João Batista
authors.initials: JB
authors.lastname: Ribeiro
authors.forename: Sheron Hellen
authors.initials: SH
authors.lastname: da Silva
authors.forename: Daniel Fachinelli Felix
authors.initials: DF
authors.lastname: de Oliveira
authors.forename: Matheus Fernando Felix
authors.initials: MF
authors.lastname: Ribeiro
keywords: Anemia, sickle cell; Hemoglobinopathies; Home visit; Pain measurement; Primary healthcare